Maintenance therapy of low-dose nivolumab, S-1, and leucovorin in metastatic pancreatic adenocarcinoma with a germline mutation of MSH6: A case report

被引：3

作者：

Peng, Shang-Hsuan ^{[1
,2
]}

Chen, Bang-Bin ^{[3
]}

Kuo, Ting-Chun ^{[4
]}

Lee, Jen-Chieh ^{[5
]}

Yang, Shih-Hung ^{[1
,6
]}

机构：

[1] Natl Taiwan Univ Hosp, Dept Oncol, Taipei, Taiwan

[2] Dept Oncol, National Taiwan Universi, Yunlin, Taiwan

[3] Natl Taiwan Univ Hosp, Dept Med Imaging & Radiol, Taipei, Taiwan

[4] Natl Taiwan Univ Hosp, Dept Traumatol, Taipei, Taiwan

[5] Natl Taiwan Univ Hosp, Dept Pathol, Taipei, Taiwan

[6] Natl Taiwan Univ Coll Med, Grad Inst Oncol, Taipei, Taiwan

来源：

FRONTIERS IN IMMUNOLOGY | 2022年 / 13卷

关键词：

pancreatic ductal adenocarcinoma; nivolumab; maintenance therapy; mismatch repair; case report; CANCER; SAFETY;

D O I：

10.3389/fimmu.2022.1077840

中图分类号：

R392 [医学免疫学]; Q939.91 [免疫学];

学科分类号：

100102 ;

摘要：

Immune checkpoint inhibitors (ICIs) provide substantial benefits to a small subset of patients with advanced cancer with mismatch repair deficiency (MMRD) or microsatellite instability (MSI), including patients with pancreatic ductal adenocarcinoma (PDAC). However, the long duration of ICI treatment presents a considerable financial burden. We present the case of a 63-year-old woman with metastatic PDAC refractory to conventional chemotherapy. Genetic analyses identified an MSH6 germline mutation and a high tumor mutation burden (TMB). Complete response (CR) was achieved after a short course of low-dose nivolumab (20 mg once every 2 weeks) with chemotherapy. CR was maintained for over 1 year with low-dose nivolumab and de-escalated chemotherapy without any immune-related adverse events. This case supports the further exploration of low-dose, affordable ICI-containing regimens in patients with advanced MSI-high/TMB-high cancer.

引用

页数：5

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